Nontraumatic parietal subcortical hemorrhage: clinical-computed tomographic correlations.

The clinical and computed tomographic findings in 25 patients with parietal lobe hematomas are discussed. Six patients had anterior-lateral parietal hematomas (18 to 36 mm). These patients were normotensive. No etiology was delineated even when angiography was utilized. Six patients had medial parietal hematomas (12 to 24 mm) with extension to the thalamus. Two patients were normotensive and six were hypertensive. Three patients had posterior parietal hematomas (10 to 18 mm). These patients were hypertensive. Eight patients had parietal hematomas extending to the temporal and frontal region (30 to 60 mm). Three of these patients died. Four patients were normotensive and four were hypertensive. One of these normotensive patients had cerebral metastases. Two patients had parietal hematomas which extended to the occipital region (20 to 34 mm). These patients were normotensive. Peripheral rim enhancement was demonstrated on follow-up CT scan (performed 2 to 4 weeks after the initial study) in 14 of 21 cases. On follow-up CT of the 21 surviving patients with parietal hematomas (excluding the case due to metastases) performed more than 4 weeks after the clinical ictus, 14 appeared hypodense and 7 appeared isodense. Residual neurological deficit and recurrent seizures were more frequent if the hematoma "aged" to a hypodense appearance.